Department of Medicine, Örebro University, Örebro, Sweden.
J Pediatr. 2013 Jul;163(1):237-42. doi: 10.1016/j.jpeds.2012.12.087. Epub 2013 Feb 8.
To provide risk estimates for celiac disease (CD) in Down syndrome (DS) compared with the general population.
In this nationwide Swedish case-control study, we examined the risk of CD in individuals with DS born between 1973 and 2008. Study participants consisted of 2 populations: 11,749 patients with biopsy-verified CD (villous atrophy [VA], equivalent to Marsh grade III) who were identified through histopathology reports from the 28 pathology departments in Sweden and 53,887 population-based controls matched for sex, age, calendar year of birth, and county of residence. We used prospectively recorded data from Swedish health registers to identify individuals with DS. ORs were calculated using conditional logistic regression.
Of the 11,749 individuals with CD, 165 had a diagnosis of DS (1.4%) compared with 55/53,887 controls (0.1%). This corresponded to an OR of 6.15 (95% CI = 5.09-7.43) for subsequent CD in individuals with DS compared with the general population. The association between DS and CD was not affected by maternal age at delivery, infant sex, or presence of type 1 diabetes mellitus in the child.
We found a sixfold increased risk of CD in individuals with DS. This study adds precision to the previously reported association between DS and CD.
与普通人群相比，评估唐氏综合征（DS）患者罹患乳糜泻（CD）的风险。
在这项全国性的瑞典病例对照研究中，我们研究了 1973 年至 2008 年间出生的 DS 患者罹患 CD 的风险。研究参与者包括 2 个人群：11749 名经活检证实的 CD 患者（绒毛萎缩[VA]，相当于 Marsh 分级 III），这些患者通过瑞典 28 个病理科的组织病理学报告被识别；53887 名基于人群的对照者，按照性别、年龄、出生日期和居住县与患者相匹配。我们使用瑞典健康登记处的前瞻性记录数据来识别 DS 患者。使用条件逻辑回归计算比值比（OR）。
在 11749 名 CD 患者中，有 165 名（1.4%）诊断为 DS，而在 53887 名对照者中，有 55 名（0.1%）（OR=6.15，95%CI=5.09-7.43）。与普通人群相比，DS 患者发生 CD 的风险增加了 6 倍。DS 与 CD 之间的关联不受产妇分娩年龄、婴儿性别或儿童是否患有 1 型糖尿病的影响。
我们发现 DS 患者罹患 CD 的风险增加了 6 倍。本研究为之前报道的 DS 与 CD 之间的关联提供了更精确的信息。
